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12 essential ultrasound findings for intermediate-level sonographers

Release time:

2025-03-12 09:38

(1) Bull's-eye sign(bulls eye sign) orTarget signOn ultrasound, this appears as a hyperechoic area (tumor tissue) surrounded by a ring of hypoechoic tissue (acoustic halo), with a possible central area of liquefactive necrosis that is hypoechoic or anechoic, resembling a "target" or "bull's-eye" sign.This is often seen in metastatic liver tumors.。

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(2) Pseudokidney signThis isa characteristic ultrasound finding in gastrointestinal tumors.The thickened hypoechoic gastrointestinal wall surrounds the hyperechoic intestinal contents and gas,resembling a cross-section of a kidney on ultrasound, hence the term "pseudokidney" sign.Ultrasound Dharma Academy notes: This sign is also often seen in patients with intussusception, or in diseases causing intestinal wall thickening due to inflammation, edema, or abscess (such as intestinal tuberculosis, Crohn's disease, etc.).

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Patients with colon cancer

Rola S, Migryt E, Prystupa A, et al. The value of abdominal ultrasound in the diagnosis of colon cancer–Case report[J]. Journal of Pre-Clinical and Clinical Research, 2017, 11(2): 160-161.

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Patients with intussusception

(3) Comet tail signThis is produced when the sound beam encounters a thin, strongly reflective interface.Multiple reverberation artifacts "internal reverberation"(internalreverberation) resulting ina band of strong echoes that gradually converges and weakens from the strongly reflective interface, resembling a comet's tail,which is characteristic. Often seen incholesterol crystals or microliths in the gallbladder wall, crystals in colloid cysts of the thyroid gland, and metallic foreign bodies in the body, intrauterine devices.

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(4) Wall-Hyperechoic-Shadowing(wall-echo-shadow, WES sign)The sign of a hyperechoic area with posterior shadowing within a shrunken, thickened gallbladder wall containing stones，is a diagnostic criterion for chronic cholecystitis with stones.W-wall (hypoechoic gallbladder wall); E-echo (hyperechoic stone); S-shadow (shadowing)

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(5) Sleeve sign：A specific ultrasound finding in the longitudinal section of the intussuscepted bowel during intussusception.，The shape is like a sleeve. Its cross-section resembles concentric circles, called the "concentric circle" sign.

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(6) Peak sign：Patients with retroperitoneal tumorsThe phenomenon of the bowel passing in front of the tumor during respiration. Helpful in differentiating the location of the tumor.

(7) Hump sign(hump sign): A sign where a liver tumor protrudes in an arc shape from the liver capsule.Ultrasound Dharma Academy notes: Also used to describe normal variations in kidney contour.

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Liver hump sign

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Kidney hump sign

(8) Hypoechoic halo（Hypoechoic halo sign）A thin, hypoechoic band around the liver tumor,possibly indicating tissue edema. It is a sign of malignant tumor.

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Liver metastases

Shankar A, Varadan B, Kalyanasundaram S, et al. Hypoechoic halo sign: liver metastases[J]. Abdominal Radiology, 2020: 1-2.

(9) Fat-fluid level sign(fat-fluid level sign): The presence of liquid fat and effusion in the cyst, with a horizontal interval reflection sign at the interface between the two on the sonogram, becauseof the specific gravity, the fat liquid is on top and the water-like cystic fluid is at the bottom, forming a fat-fluid level.The sonographic appearance of fat liquid and water-like cystic fluid stratification,is a specific sign of teratoma.

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(10) Double bubble sign：The sonographic sign of fetal duodenal atresia.

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(11) Color mosaic signColor Doppler blood flow imaging,color aliasing artifact formed by high-velocity blood flow in the area of vascular stenosis.

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(12) Mickey Mouse sign(Mickey sign): Whenperforming a transverse scan of the hepatic hilum, the so-called“MickeyMouse” sonographic image is obtained, with the inferior vena cava as the“MickeyMouse” body,the portal vein constitutesthe “Mouse” head,“Mickeythe hepatic artery as its left ear, and the common bile duct as its right ear.It can help confirm the complex structure of the hepatic hilum, and is particularly helpful in distinguishing the common bile duct and hepatic artery.

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